Nebulized analgesia during laparoscopic appendectomy (NALA): A randomized triple-blind placebo controlled trial

This Level I randomized controlled trial evaluated nebulized ropivacaine versus placebo during laparoscopic appendectomy in 116 pediatric patients aged 7-17 years. Results showed no reduction in morphine consumption or pain scores, with surgeons reporting impaired visualization in 63% of cases, leading investigators to conclude the technique is not warranted for uncomplicated appendicitis.